RESUMEN
BACKGROUND: Tsukamurella spp. are obligate aerobic, gram-positive, non-motile, and slightly acid-fast bacilli belonging to the Actinomycetes family. They share many characteristics with Nocardia, Rhodococcus, Gordonia, and the rapidly growing Mycobacterium species. Therefore, standard testing may misidentify Tsukamurella spp. as another species. Accurate and rapid diagnosis is critical for proper infection management, but identification of this bacterium is difficult in the standard laboratory setting. CASE PRESENTATION: A bloodstream infection caused by a gram-positive bacterium and related to a central venous catheter was identified in an immunocompromised 2-year-old girl. Tsukamurella tyrosinosolvens was identified by modified secA1 sequencing. Antibiotic treatment and removal of the central venous catheter resolved the infection. Inappropriate management of the catheter during an overnight stay outside of the hospital was considered as a possible source of infection. CONCLUSIONS: SecA1 sequencing may be a useful diagnostic tool in the identification of T. tyrosinosolvens. Providing proper central venous catheter care instructions to patients, their families, and medical staff is important for infection prevention.
Asunto(s)
Actinobacteria , Actinomycetales , Infecciones Relacionadas con Catéteres , Catéteres Venosos Centrales , Sepsis , Preescolar , Femenino , Humanos , Actinobacteria/genética , Actinomycetales/genética , Bacterias Aerobias , Infecciones Relacionadas con Catéteres/diagnóstico , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/microbiología , Sepsis/microbiologíaRESUMEN
PURPOSE: To evaluate the ability of automated software to quantify uterine peristalsis on cine magnetic resonance imaging (MRI). MATERIALS AND METHODS: At 1.5T, half-Fourier acquisition single-shot turbo spin echo (HASTE) techniques were used to obtain 60 serial images over 3 minutes (TR/TE 3000/80 msec) in a midsagittal plane of the uterus. Thirty-two cine MR datasets, obtained from 16 healthy females, were analyzed. Uterine peristalsis was defined as the traveling waves of decreasing signal intensity on the endometrium-junctional zone border. The software detected traveling waves by identifying the neighboring areas showing similar patterns of signal intensity decrease in a different timing. Quantification of uterine peristaltic wave using the fully automated software was compared to qualitative visual evaluation by two readers. RESULTS: The mean number (and standard deviation) of peristaltic waves detected by the fully automated software and visual evaluations (readers 1 and 2) were 5.4 (3.0), 4.7 (3.1), and 4.5 (3.1) per 3 minutes, respectively. Quantification by fully automated software demonstrated excellent agreement with repeated measurement (weighted kappa 0.99) and with qualitative visual evaluations (range 0.89-0.95), comparable to interreader agreement by visual evaluations (range 0.89-0.93). CONCLUSION: The fully automated software can be used to quantify uterine peristalsis comparable to visual evaluation.